National Provider Identifier [NPI]: |
1548339153 |
Last Name Of The Provider |
HULLFISH |
First Name Of The Provider |
KATHIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
LEE ST FL 3 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLOTTESVILLE |
Zip Code Of The Provider |
229080001 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
485 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
315489 |
Total Medicare Allowed Amount |
91485.16 |
Total Medicare Payment Amount |
68925.98 |
Total Medicare Standardized Payment Amount |
70492.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
485 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
315489 |
Total Medical Medicare Allowed Amount |
91485.16 |
Total Medical Medicare Payment Amount |
68925.98 |
Total Medical Medicare Standardized Payment Amount |
70492.35 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
250 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
240 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7886 |